Tailored Treatment for Your Valvular Heart Disease (Video)

Physician guidelines lower threshold for intervention

Patients with valvular heart disease should receive treatment that’s individualized for the best chance to achieve improved heart function and a better quality of life, says newly released treatment and classification guidelines.

The American College of Cardiology and American Heart Association recently issued the new guidelines. The guidelines help doctors decide what treatments are best for their patients. The last update to the guidelines was in 2008.

What is valvular heart disease?

Valvular heart disease occurs when your heart’s valves – which regulate blood flow and prevent blood from backing up in the heart or flowing in the wrong direction – do not work correctly. As a result, the heart has to work harder to circulate the right amount of blood through the body.

There are a number of types of valvular heart disease. Some people are born with it. Others acquire the condition later in life through an infection, coronary artery disease or other cause.

Left untreated, valvular heart disease can reduce your quality of life. The disease also can be life-threatening.

In many cases, surgeons can repair or replace the valves to restore normal function. This can allow the patient to resume normal activities.

Tailored treatment

One important aspect of the new guidelines is its recommendation that patients should receive individualized treatment, says cardiologist James Thomas, MD.

Dr. Thomas, of Cleveland Clinic’s Sydell and Arnold Miller Family Heart & Vascular Institute, is a member of the committee that wrote the new guidelines.

“No patient is the same and they must have tailored therapy for their particular situation,” Dr. Thomas says.

The guidelines also recommend that it’s best for patients with advanced disease to seek treatment in a Heart Valve Center of Excellence either through consultation or referral. There, a team of physicians, which can include a cardiologist, cardiac surgeon, cardiac imager and anesthesiologist, can appropriately evaluate the patient.

This interdisciplinary medical team has the best chance to come up with the optimal plan for treatment, Dr. Thomas says.

Other aspects

The new guidance now includes recently developed therapies such as transcatheter aortic valve replacement. This therapy, a minimally invasive technique for replacing a diseased aortic heart valve, has been available only since late 2011.

The new guidelines also:

include a formula by which doctors can assess risk for patients they are considering for intervention

recommend which patients should receive surgery and which should receive other interventions

update how doctors classify disease severity

Why revisions were necessary

Several factors prompted the guidelines revision, Dr. Thomas says.

One reason is that doctors now better understand the disease. Another is that surgical interventions are more improved.

“Since our surgical interventions have become safer, there has been some momentum toward making surgery available to patients,” Dr. Thomas says. “We have more information on these diseases and we better understand why it’s important to intervene sooner rather than later.”